The high prevalence of NIDDM together with its devastating complications and costs have made this community health problem one that particularly threatens the struggle of Native Americans to maintain independence. The overall goal of this proposal is to empower the Akwesasne Community to develop programs aimed at preventing diabetes and its complications in Native American Mohawks. The process will be initiated by: 1. developing a data base concerning diabetes and its complications by using the existing computerized data base of the St. Regis Mohawk Health Services; and developing an understanding of the beliefs and attitudes related to this condition by using semistructured personal interviews, focus groups and a household survey; 2. identifying and bringing together a planning group of locally influential Native Americans to form the core of a community coalition which will develop and implement programs to prevent diabetes and its complications; 3. providing feedback to the community about the extent of diabetes as the basis for gaining community involvement and the sense of ownership necessary to develop programs to attack this disorder; 4. undertaking a feasibility pilot study to investigate the role of energy expenditure in children during the development of obesity using the techniques of doubly labeled water and indirect calorimetry in the field; 5. establishing a baseline for collecting information for subsequent program evaluation. The initial planning process will be carried out by an advisory group from Akwesasne who will supply information about the community needs and wishes and provide access to the health care data base, and a broad based group of investigators from the University of Vermont who will contribute expertise in the areas of health promotion, cross cultural communications, biostatistics and clinical investigation. Once established the community coalition will seek further funding to provide staffing and educational resources to enable it to function effectively over several years and eventually become self-sustaining.